Antibiotic Awareness Week

18 – 24 November 2019

World Antibiotic Awareness Week occurs annually in November. It aims to draw attention to the role of effective use of antibiotics in preventing and containing antimicrobial resistance (AMR). Antibiotics are a type of antimicrobial. Antibiotic Awareness Week is a key initiative to promote the correct use of antibiotics to contribute to the avoidance of further emergence and spread of AMR. AMR is already affecting the care of patients now and current trends indicate this will have an increasing impact over time.

What is antibiotic resistance?

Antibiotic resistance is the ability of a micro-organism (such as bacteria) to stop an antibiotic from working effectively. Whilst antibiotics have the potential to treat infections, use of antibiotics can also contribute to the problem of antibiotic resistance.

Why is antibiotic resistance such a major concern?

Antibiotics are lifesaving medications, but only if they work against the organism causing infection. If we don’t address the issue of antibiotic resistance there may be infections for which there are no available treatments. Antibiotic resistance may impact on life saving health care, such as cancer treatments or organ transplants, as antibiotics will not be effective to prevent infections that are commonly associated with these procedures.

The World Health Organisation has described antibiotic resistance as one of the greatest threats to human and animal health, as well as food and agriculture

Why is the correct use of antibiotics important?

Unlike other medications, the development of antibiotic resistance from the over use of antibiotics can affect not only the patient needing treatment now, but also future patients and the wider community. Antibiotic use inevitably leads to resistance, but overuse of antibiotics has accelerated this process. Some antibiotics are no longer able to be used to treat infections.

It is important to take antibiotics as prescribed by doctors and not to pressure doctors for antibiotics if they feel they won’t help your situation. Saving antibiotic prescriptions for later or taking someone else’s can mean you aren’t getting the right antibiotic at the right dose for your needs.

Can’t we just develop new, stronger antibiotics?

The development of new antibiotics is challenging, expensive, and takes a long time to deliver to market. Because of this, the number of new antibiotics has been decreasing over time.

What can be done now?

We must ensure that antibiotics are only taken when they are absolutely needed, in the most appropriate way for the shortest period of time. It is an issue that demands action on every level, from individuals, governments and major organisations around the world. Without urgent action, infections and minor injuries could once again become fatal.

Many clinicians and organisations participate in Twitter discussions during Antibiotic Awareness Week to learn more about the importance of safe and appropriate antibiotic use in addressing the problem of antibiotic resistance and improving patient care.

An annual event is the global Twitter chat coordinated by the European Centre for Disease and Prevention and Control. To keep up to date on the global chat and on topics relevant to Antibiotic Awareness Week, follow the Commission on Twitter @ACSQHC.

Australia’s response to Antimicrobial Resistance – A National Strategy

Antimicrobial resistance involves a complex interplay of environmental, clinical and behavioural factors in humans, animals and agriculture. To achieve real progress, Australia’s response needs to be integrated across all these sectors.

In June 2015, the Australian Government released the first National Antimicrobial Resistance Strategy to guide the response to the threat of antibiotic misuse and resistance. The strategy focuses on measures to prevent antibiotic resistance as well as decrease inappropriate use of antibiotics across all sectors where antibiotics are used.

The Antimicrobial Stewardship (AMS) Clinical Care Standard aims to ensure that a patient with a bacterial infection receives optimal treatment with antibiotics – the right antibiotic to treat their condition, the right dose, by the right route, at the right time and for the right duration based on accurate assessment and timely review.

Acknowledgement: Each year the Australian Commission on Safety and Quality in Health Care works with key partners from human health, animal health and agriculture to raise awareness of the problem of antibiotic resistance. Antibiotic Awareness Week has been supported by the Australasian Society for Infectious Diseases, the Australian Society for Antimicrobials, the Australasian College for Infection Prevention and Control and the Society of Hospital Pharmacists Australia.

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The Therapeutic Goods Administration (TGA) considers there is a lack of adequate scientific evidence for it to be satisfied that the risks to patients associated with the use of single incision mini‐slings for the treatment of SUI outweigh their benefits. These products have been removed from the Australian Register of Therapeutic Goods (ARTG)

* Grades of Recommendation

This pathway is adapted from UroGynaecological Society of Australasia (UGSA) Surgical treatment of SUI pathway (2016)

In the short-term there are similar success rates for retropublic and transobturator

A

Obturator tapes slightly quicker, with less blood loss, bladder perforation and voiding dysfunction difficulties. Most of these differences were small and the complications are readily able to be managed.

A

However in the medium term (>5 years) the reoperation for recurrent SUI greater in obturator group and a small number developed groin pain (3-4%) that is difficult to treat.

B

Retropubic considered as the preferred procedure with transobturator reserved for those patients with a hostile abdomen

C

* Grades of Recommendation

This pathway is adapted from UroGynaecological Society of Australasia (UGSA) Surgical treatment of SUI pathway (2016)

In the short‐term there are similar success rates for retropubic and transobturator mid urethral slings

A

Obturator tapes are slightly quicker, with less blood loss, bladder perforation and voiding dysfunction difficulties. Most of these differences were small and the complications are readily able to be managed.

A

However in the medium term (>5 years) the reoperation for recurrent SUI greater in obturator group and a small number developed groin pain (3-4%) that is difficult to treat.

B

Retropubic considered as the preferred procedure with transobturator reserved for those patients with a hostile abdomen

C

* Grades of Recommendation

This pathway is adapted from UroGynaecological Society of Australasia (UGSA) Surgical treatment of SUI pathway (2016)

Similar success rates compared to MUS with longer operating time and possibly higher voiding dysfunction; fascial sling has lower rates of chronic pelvic pain, no risk of erosion or extrusion, and higher rates of post‐operative morbidity